Life is what happens when you’re busy making plans, right?

Apr 5, 2011 | life, pregnancy, work

I think that’s how that goes, anyway.

If you’re looking for a post full of sunshine and rainbows, this ain’t it. I got some pretty crappy news today about our upcoming family-growing plans, and I’m still pretty pissed about it.

Here’s the lowdown (from what I’ve gathered thus far):

Oscar and I had plans to start trying for another baby in about a month or two. I was going to finish the current pill pack I’m on and then quit taking them, giving myself a couple months to try and get some kind of schedule back naturally. Ideally, I wanted to be able to get pregnant in July, putting us with our second baby next spring and giving us a few months before I started my student teaching so we could deal with the sleepless nights without the additional stress student teaching would bring.

I had Oscar call our insurance broker today to see about switching me back to the maternity care plan I had with Kaiser before I got pregnant with Grayson. After his birth last fall, we switched me to a different company called Coventry that had a much lower monthly premium, thinking that we could switch back to the maternity plan once we were ready to have another baby. Oscar soon found out that our insurance broker had bad news, and even worse news.
Kaiser was the LAST company to offer maternity coverage to individual health care plans, and they did away with that particular plan  I was on as of January 1st, 2011 because it was becoming extremely expensive for them. If you were still on that plan, they grandfathered you in, and you still have coverage. But since we were trying to be financially responsible, we switched my coverage over to the (cheaper!) insurance company, again thinking we could switch it back once we were ready to have a second baby. Not anymore. As far as I can tell, not one single insurance company offers maternity care, not even a rider, for an individual plan.
What does this mean for us? Basically, if we want to have another baby, EVEN THOUGH WE BOTH HAVE INSURANCE, it will cost us between $10,000 and $15,000 out of pocket because no insurance company will give me maternity coverage.
When Oscar told me this, I broke down and started bawling. I felt like I was being punished for being a responsible member of society and even BOTHERING to have an individual health care plan. He knew how upset I was and immediately called my doctor’s office and asked what the standard maternity package would cost there if we paid them straight cash. For two sonograms, all the well visits, the delivery and the post-partum visit, they estimated $3,700, with additional ultrasounds being extra, and possible other additionals. So I figured we’d just round that out to $4,000 to be safe.
As for the hospital, I remember looking at the bill we received after coming home with Grayson itemizing all the costs that Kaiser covered, and it was around $11,000. (So that’s where I came up with the between 10 and 15k total. I could be off. I didn’t major in asshole math.)
So what are our options? The easiest would be to put off having another baby until after I get my second degree and start working again so I can get insurance coverage with the county as a teacher. But as far as timing, I’m looking at 2013 or 2014, and my babies will be close to four years apart then. Plus, instead of being able to stay at home with both of them, I’ll probably have to go right back to work after my 8 weeks of maternity leave (unless we get lucky and have a late spring baby). Doable, but certainly not ideal and I don’t feel like it’s fair to my second child at all. Plus, I was starting to get really excited about going off the pill again and the idea of being pregnant and teeny tiny baby smell and all that.
Second is just saving up the money and trying to strike deals with the doctor’s office and the hospital if we offer to pay in cash for both. But to be honest, making payments on a student loan and a baby in addition to all our other bills on one income makes me nauseous. I suppose it could be done, but why would you want to??
The office manager (secretary?) at my doctor’s office told Oscar to look into Medicaid as an option, but even on one income I don’t think we come close to qualifying. It’s not totally ruled out, but I’m not banking on it.
I did a bunch of research this afternoon, and I found a couple links on the subject, if anyone else is interested:
Pregnancy Not Covered by most Individual Health Policies
Pregnancy Complicates Health Insurance Options
Health Insurance Woes: My $22,000 Bill Having a Baby
If I sound ungrateful, please understand that I don’t mean to sound like a spoiled brat. I really don’t. I realize that I’m LUCKY to have one baby and a loving husband and a huge family/friend support system. When I think about all of that my silly “timing issue” sounds absolutely ridiculous. I just we didn’t live in a country whose health care system is so ass-backwards that having a baby is a luxury that only rich people can afford.
Alright. I’m done. Off to lay and in bed and fall asleep watching King of the Hill.

3 Comments

  1. Geek in Heels

    I can completely sympathize as I have been pregnant and was on individual health insurance then (and had a rude awakening to discover that pregnancy is considered a pre-existing condition and that they wouldn’t cover me because I had not been on the plan for over a year). Even when I ended up losing that baby and needed a D&C — procedure that I NEEDED, they refused to cover it. Health insurance in our country sucks, period.

    Have you tried talking to other OBs and hospitals in your area? If you are paying in cash, usually some are willing to work out a deal. I know that my hospital has tons of programs that will help lower the bill, AND work out monthly installments.

    So sorry you’re going through this, and I hope everything works out for you.

    Reply
  2. Ashley

    Thanks again for the kind words. After getting some much-needed sleep it seemed like a much easier (although still terribly difficult) situation. I don’t want to go into debt because we want our children close in age. And of course, after reading Mandy’s latest post, I felt completely wretched after freaking out so much because financially we just can’t swing everything at once.

    I need to remind myself that spacing my babies so that we can be more ready financially for the second is *not* the end of the world, and I’m ridiculously lucky to have one strong, healthy, happy baby, and to have a supportive husband who’s ready and waiting to fork out money to put me through school for the next two years.

    But, for the record, insurance companies still suck BIG TIME.

    Reply
  3. Layla

    Oh nooooooooooooo! Are you kidding me?!?! I had no idea about this stuff…Pregnancy is a pre-existing condition?!? Well, you know my thoughts on all of this insurance crap. 🙁 This makes me angry for you – angry for everyone. 🙁 Grrrr.

    Reply

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